Lamictal side effect: Bulimia ????

Hi Karen-

I realise the bingeing and purging is a fairly new part of the eating issues for you, but restricting isn't and it is all part of the same disorder. I have trouble coming to terms with the fact that anorexia and bulimia are different sides of the same coin. I want to make the bingeing stop, but a big part of me wants anorexia back and to hold onto it.

I absolutely know what you mean- they both feel like they come from the same place. The feeling of accomplishment after I purge is exactly the same feeling when I restrict my eating. I turned the corner yesterday and was able to restrict my eating all day. It wasn't as thorough as I prefer, but I did it. No binge, no purge (though I briefly considered purging) and I know I was under 900 cal. It was a huge feeling of relief by bed time. The purging is much harder on my body than restricting. And sometimes I cry immediately after, which I hate. I know it sounds counter to the feeling of accomplishment I just described, but it's a fleeting deep saddness and shame, that's followed by the good feeling of, "I did it- I'm clean." Do you identify with this swing in mood?

Today is a good test. Friends are coming by for lunch. I'm making a large meal and I know my friends will be "watching" me (they know I restrict my eating.) And there will be the temptation to eat- and I know the need to purge would follow - so I know I need to NOT eat- but I need to be very discreet about the not eating to avoid concerning my friends. The addition of Binge/purge to my life has created quite a complicated "dance" with food. We'll see how it goes. I now understand I can have no idea what the day has in store for me.

The problem is any inpatient treatment, I find, just treats the emergency and does nothing to help in the long term.

Yup, I totally agree. I've been inpatient (for reasons other than an ED) four times. Each time, all I had to do was say what they wanted to hear to get the thumbs up for discharge. I've never been held longer than three weeks. It's surprisingly easy. Though this last time I did make a genuine effort - I'm beyond tired of living this way. They set me up with this DBT but it's not having much of an impact, despite my best efforts and participation. I do want to be well, to not be controlled by my disorders. Even feeling in a fine mood as I do at this moment, I know that I can only tolerate this for so long. Suicidality is a sober consideration for me. There are really only a scant few things keeping me here.

Actually I don't and do many self destructive things. I know the all the theories of what can possibly help with this and what might make changes but putting them into practice myself is difficult.

This is how I feel about DBT. The skills are designed to help- but applying them is much easier said than done. And even when I can apply them, often they fall short of actually helping. And every time the skills fail, I lose a little faith in the possibility of actually getting better. I lose the desire to try again next time. Do you mind if I ask what your other self-destructive behaviors are? I've struggled with SI behavior at times in my life.

I've started keeping a journal of my moods around moments of urges to binge. I just write, without thinking. And I try to avoid reading what I've written. I'll bring this to my next individaul session. Thanks for the suggestion- it's right along the lines of what she suggested as my homework.

I do think the Prozac has helped me with the impulse control. I've read it's actually prescribed to treat bulimia. But not anorexia, b/c it suppresses the appetite. But that works just fine for me!

Hi Stella

I'm glad you had a good day yesterday and felt the bingeing was a lot more under control. However, once someone develops an eating disorder problem it is very difficult to eat in a controlled way. As you noted, the way you have taken back 'control' from bulimia is by restricting. This is what I do too and I haven't ever managed to find a middle ground since my eating disorder started.

And sometimes I cry immediately after [purging], which I hate. I know it sounds counter to the feeling of accomplishment I just described, but it's a fleeting deep saddness and shame, that's followed by the good feeling of, "I did it- I'm clean." Do you identify with this swing in mood?

Yes, absolutely. I mean, I feel most horrified with myself for bingeing, but then I feel just as disgusted with myself for purging too, because I think other people would find it repulsive. I have a compulsion to do it because I know I will feel empty, clean and therefore 'good' when the food is gone, but the actual act of purging is in no way pretty or nice. I think my mood is most stable when I am restricting but this brings other stresses, like threats of hospitalisation etc and basically it is just another way to try to feel better about myself that is short lived when the bingeing returns.

How did your lunch with friends go? I too feel under pressure not to eat in front of people and eat mostly in secret. When I was severely anorexic I avoided eating with others because everyone has this image of an anorexic person never eating a single thing and I felt I needed to live up to that. Now I avoid eating with others because I feel such a failure at anorexia and I think people will be thinking how fat I am and watching everything I eat.

Anyway, I hope your lunch was a success and you were able to enjoy being with friends without thoughts of food dominating the event completely.

I have always found inpatient treatment makes me worse because all control is taken from me and when admitted for anorexia it is not always that easy to get out of hospital once you have been admitted. I had a real struggle last time and the experience has left a lasting and traumatic effect.

Suicidality is a sober consideration for me. There are really only a scant few things keeping me here.

Yes, I understand totally where you are coming from with this as I often feel the same. I think about it a lot, but so far thoughts of upsetting the people I care about and the very few people who care about me has stopped me.

Do you mind if I ask what your other self-destructive behaviors are? I've struggled with SI behavior at times in my life

They are numerous and I am not proud of what I do or have done. At times they are deliberate acts of injuring myself - hitting myself, cutting, overdoses (but not enough to die), misusing tranquilliser and sleeping drugs, slimming pills and laxatives. I also drink sometimes so that I can purge as I cannot tolerate alcohol. A lot of the self destructive stuff now is related to my eating disorder, with methods of purging, but I also do it when I can't cope with my emotions.

Maybe I should've given the Prozac a go but I was scared at the time because I've read reports of weight gain and loss and it is hard to know what to believe. I'll be interested to hear how you get on with it. I am pretty desperate right now.

I hope you've had a good day Stella.

Karen

This research suggests that Bulimia can be caused by biochemical problems! So I might not be too off base with wondering if the Lamictal caused my issues...

A disorder can be caused by such things like obsessive compulsive disorder, depression or in the case of bulimia patients abnormally low serotonin levels.

Patients with severe obsessive compulsive disorder, depression or bulimia patients were all found to have abnormally low serotonin levels. Neurotransmitters such as serotonin, dopamine and norepinephrine are secreted by the intestines and central nervous system during digestion.

Researchers have also found low cholecystokinin levels in bulimics. Cholecystokinin is a hormone that causes one to feel full and decreases eating. Low levels of this hormone are likely to cause a lack of satiative feedback when eating, which can lead to overeating. Another explanation researchers found for overeating is abnormalities in the neuromodulator peptides, neuropeptide Y and peptide YY. Both of these peptides increase eating and work with another peptide called leptin. Leptin is released by fat cells and is known to decrease eating. Research found the majority of people who overate produced normal amounts of leptin but they might have complications with the blood-brain barrier preventing an optimal amount to reach the brain.

Cortisol is a hormone released by the adrenal cortex which promotes blood sugar and increases metabolism . High levels of cortisol were found in people with eating disorders. This imbalance may be caused by a problem in or around the hypothalamus. A study in London at Maudsley Hospital found that anorexics were found to have a large variation of serotonin receptors and a high level of serotonin.

Many of these chemicals and hormones are associated with the hypothalamus in the brain .Damage to the hypothalamus can result in abnormalities in temperature regulation, eating, drinking, sexual behavior, fighting, and activity level.

briary wrote:...once someone develops an eating disorder problem it is very difficult to eat in a controlled way. As you noted, the way you have taken back 'control' from bulimia is by restricting. This is what I do too and I haven't ever managed to find a middle ground since my eating disorder started...

This is my greatest fear! And I see the pattern emerging, just like you describe. I don't want to become "addicted" to this pattern of eating or not eating. I can't remember what it's like to eat without worrying about it- without being hyper-sensitive to everything I put in my mouth.

How did your lunch with friends go?... Anyway, I hope your lunch was a success and you were able to enjoy being with friends without thoughts of food dominating the event completely.
I too feel under pressure not to eat in front of people and eat mostly in secret. When I was severely anorexic I avoided eating with others because everyone has this image of an anorexic person never eating a single thing and I felt I needed to live up to that. Now I avoid eating with others because I feel such a failure at anorexia and I think people will be thinking how fat I am and watching everything I eat.

I know what you mean. I have experienced the need to "live up to" not eating for the sake of what others think of me. I feel like it makes me appear strong in will, to be able to say no to food, to be thin.
The lunch didn't go well. I ate and then constantly obsessed about purging- just as you put it, the food dominated completely. It's terrible to admit, but I couldn't wait for them to leave so that I could purge. I hate to say that b/c one of them has been a dear friend for many years- and I do so enjoy her company and am grateful to have her friendship. But the need to purge is SO overwhelming and powerful- it's like a loud noise I can't ignore. I knew every minute spent meant it would be that much harder to throw all of the meal up. And sure enough, I could only get about 1/3 of it out. I ended up taking a laxative.

I have always found inpatient treatment makes me worse because all control is taken from me and when admitted for anorexia it is not always that easy to get out of hospital once you have been admitted. I had a real struggle last time and the experience has left a lasting and traumatic effect.

I see. It must be much harder to be discharged for an ED b/c you have to gain weight back. There's no faking that.

Suicidality...
Yes, I understand totally where you are coming from with this as I often feel the same. I think about it a lot, but so far thoughts of upsetting the people I care about and the very few people who care about me has stopped me.

Yup, that's what's stopped me in the past. Two people- my partner and my psychiatrist. I say it's love and hope. My partner loves me so much and my psychiatrist has the most sincere hope that I can beat these disorders and become a happy, fulfilled human being. They both believe in me so much, it tears at my heart to imagine their hurt and defeat if I killed myself. At times I've felt resentful and angry towards them for this - they can't ever know how painful it is to keep pushing forward.

They are numerous and I am not proud of what I do or have done. At times they are deliberate acts of injuring myself - hitting myself, cutting, overdoses (but not enough to die), misusing tranquilliser and sleeping drugs, slimming pills and laxatives. I also drink sometimes so that I can purge as I cannot tolerate alcohol. A lot of the self destructive stuff now is related to my eating disorder, with methods of purging, but I also do it when I can't cope with my emotions.

I'm so sorry about your pain. Thanks for sharing- it's good to connect with someone who has similar behaviors. I can identify with the physical abuse. I also cut, burn, and stab myself when my emotions are just through the roof and I can't stand it anymore. The shame I feel when I self injure is exactly the same shame as when I purge. And the need to be ultra careful so no one wonders about the wounds is tricky. I take Ativan at times when the obsessions just won't leave me be. It quiets the noise in my head. The drinking until you're sick in particular sounds so awful. I couldn't handle that. I really feel for you.
My day wasn't so great, yesterday, but today is a new one! I'm going to try the best I can- I feel optimistic. I'm not working today, but I have plans for most of the day, so that will help.
Thanks again and thinking of you- hoping you're able to take things one moment at a time, as they come.

I take 550mg Lamictal, 1200mg Tegretol Retard & 250mg Keppra for Epilepsy - drugged up to the eyeballs. I can't honestly say I have found I eat loads more since being on Lamictal, as I've been on it for 20 years now, as was a guinea pig in a 2 year drug trial for the drug for 2 years prior to it becoming a Licensed drug.

Obviously I take it for different medical reasons to yourself, whether than would make any difference I don't know. But haven't noticed anything out of the norm in that respect.

Neurotic wrote:I take 550mg Lamictal, 1200mg Tegretol Retard & 250mg Keppra for Epilepsy - drugged up to the eyeballs. I can't honestly say I have found I eat loads more since being on Lamictal, as I've been on it for 20 years now, as was a guinea pig in a 2 year drug trial for the drug for 2 years prior to it becoming a Licensed drug.

Obviously I take it for different medical reasons to yourself, whether than would make any difference I don't know. But haven't noticed anything out of the norm in that respect.

Thanks for sharing your experience.

Wow you're really on a high dose of Lamictal. I understood the top of the dosage to be 400 MG.

One thing I've learned about Lamictal is it could affect the chemistry that tells the body to "turn off" hunger- and also affects impulse control. But it doesn't seem like that's true for most people, like yourself.

Thanks -

Hi Stella

Sorry you had problems with your lunch with your friends. I often feel guilty that I can't allow myself to be normal with my friends as the eating disorder rules my life. Don't give yourself a hard time for not being able to resist purging, but please be careful. Purging by vomiting and laxative abuse is what does the real damage to the body, and once the behaviour starts it soon becomes a pattern that is difficult to break. I used to severely abuse laxatives, swallowing them by the handful and my digestive system is now severely messed up as a result.

I can't remember what it's like to eat without worrying about it- without being hyper-sensitive to everything I put in my mouth.

Yes I feel like this too. I have a fear of food now.

Suicidality...
Yup, that's what's stopped me in the past. Two people- my partner and my psychiatrist. I say it's love and hope. My partner loves me so much and my psychiatrist has the most sincere hope that I can beat these disorders and become a happy, fulfilled human being. They both believe in me so much, it tears at my heart to imagine their hurt and defeat if I killed myself. At times I've felt resentful and angry towards them for this - they can't ever know how painful it is to keep pushing forward.

It is true that I don't think anyone who hasn't ever felt suicidal can truly understand what it is like. I don't really feel anger or resentment towards people who care about me, but I do feel extreme guilt at what I would be doing to them by dying. I also wish they could understand that I just want out of my life and by dying I would finally be at peace, but I realise that is too much to ask.

How are you today? Sorry I've not been around much but I'm struggling myself right now.

Karen

Hi Karen-
Update on the Prozac. Most notable side effects: dry mouth and trouble falling asleep. My mood swings have been off the charts. In the morning I can be manic high and by evening absolutely despairing, dispondant, and hopeless. So I do think it exacerbates my Bi-polar condition. That said, I've noticed a HUGE difference in my appetite (greatly decreased) and lessended urges to binge. The past two days I haven't had any major urge to binge- some urges to eat junk food, but resisted without much trouble. Yesterday I restricted my eating all day with great success. I know this isn't exactly good "success" - but limiting calorie intake is worlds easier on my body as a whole than the binge/purge cycle. Lastly, and not so good, I think it has increased my suicidality. I wasn't thinking about it all all before Prozac- and now I find myself thinking about it throughout the day the past week or so. I even parked at my plan site yesterday- something I've never done. (It was a strange sensation- peaceful and calming.) Since you also tend towards suicidality, I think this may be an important consideration.

Thanks for the warning about laxative abuse. I'll take your experience to heart. That's awful you have permanent injury from it. I only do it as a last resort- when I just can't purge any other way. I know that when I take too many, too often it causes me constipation, so I like to avoid that!

Sorry to hear you've been having a rough time these days. Do you get seasonal depression? I don't know about your corner of the world, but here it's getting dark by 3:30 in the afternoon- every year I have a hard time adjusting to all of the darkness.

I do very much appreciate your posts, but don't worry about times you don't feel like it. I understand when folks don't reply. This a depression forum and isolation is part of the illness. So I understand very well.

Hi Stella

It is good to hear from you today and to hear that the Prozac is helping in some ways. However, the negative effects on the bi-polar and also thoughts of suicide could be reasons for concern. When do you next see your psychiatrist or doctor? Perhaps this medication is not the right one for you, but in any case it seems your mood needs to be closely monitored.

Although I have always been very against antidepressant medication in the past, I think I feel so desperate to break the binge cycle that I might be prepared to give Prozac a try, having heard from you that it has helped reduce the compulsion to binge. My main problem though is my total mistrust of doctors and psychiatrists, to the extent that I do not currently have a doctor at all, and I am not sure I can get over my fear enough to see someone to get a prescription.

Also, trouble sleeping would be a problem for me as I already suffer from chronic insomnia, so I don't know

Lastly, and not so good, I think it has increased my suicidality... I even parked at my plan site yesterday- something I've never done. (It was a strange sensation- peaceful and calming.)

I would strongly suggest you speak to your psychiatrist, doctor or therapist about this. I've experienced that feeling of peace and calm you mention. It was at a time I had made a definite decision to end my life, planned it out and everything. I think it is probably the relief of thinking the daily struggle and distress would finally be over, and maybe thoughts of being free. Obviously I didn't act on my plan at that time, probably because I can't bear the thought of the people I would be leaving behind.

I'm glad my experience of laxative abuse has given you second thoughts. It is really damaging and although I felt empty and therefore 'good' when I'd done it, all evidence suggests it doesn't prevent absorption of calories, so although it feels like it is doing something it isn't really.

Also try if you can to nurture your body with sufficient food, rather than severely restricting. I know too well that it feels good to do, but it is a trap that is hard to break free from.

Sorry to hear you've been having a rough time these days. Do you get seasonal depression? I don't know about your corner of the world, but here it's getting dark by 3:30 in the afternoon- every year I have a hard time adjusting to all of the darkness.

I've never officially been diagnosed with seasonal depression and although I do sometimes think my mood dips during the winter months, this year I have been pretty severely depressed for most of the time. I always used to look forward to summer with the better weather and lighter days, but that was when I was in my anorexic phase. Since bulimia has been more prominent I found I dreaded summer, as I felt hot but wanted to cover up the whole time no matter what the temperature. I also find I prefer the darker nights, and also bad weather, but I think it is to do with my terrible self image problems and the way I hate suffering from bulimia.

I hope you don't mind, but since we now have an eating disorder forum here, I have moved this post to that section, as it seems more appropriate.

Karen

Hi Karen-
Thanks for being so attentive to my posts and questions.

My main problem though is my total mistrust of doctors and psychiatrists, to the extent that I do not currently have a doctor at all, and I am not sure I can get over my fear enough to see someone to get a prescription.

Have you always feared doctors? Did something traumatic happen- like one involuntarily committed you to the hospital? I realize it's what help looks like, but it also feels like such a GIANT breech of trust. I think many doctors are just stuffed shirts- and even dangerous in the careless mistakes they make. But there are some REALLY good eggs out there, too. I've been seeing a psychiatric nurse practitioner for over a year now regarding medication management and she's been a godsend. She's good at what she does. But I DEFINITELY distrust therapists in particular. DBT class requires a once weekly individual therapy session and I dread it. I still haven't been able to get on board with this therapist. I'm so guarded, I carefully consider and control everything I say. But I've been heart broken by "bad" therapists in the past. I have an attachment disorder and now understand that most therapists don't know how to help me manage it- even when I explain that I have it and require help. So I have to be especially vigillant.

If it's any consolation, my experience in seeing a psychiatrist for medication management specifically is quite different than seeing one for therapy. They don't dig around in your past or mess with your psyche like therapy does. They don't try get you to process stuff emotionally. They just get the facts, note your symptoms, and make suggestions on medications to try. I've been through a lot of medications this past year, but we finally got to Lamictal and it's been helping hugely. Well, with the Bipolar and Depression ,at least. Not so much with the ED stuff.

I would strongly suggest you speak to your psychiatrist, doctor or therapist about this. I've experienced that feeling of peace and calm you mention. It was at a time I had made a definite decision to end my life, planned it out and everything. I think it is probably the relief of thinking the daily struggle and distress would finally be over, and maybe thoughts of being free. Obviously I didn't act on my plan at that time, probably because I can't bear the thought of the people I would be leaving behind.

This is one of the hardest things to bring up to anyone in "real" life. Harder even than my food problems. I feel like such a fraud. As if; Why am I still here if I'm saying I'm suicidal? I think I buy into the rhetoric and common criticism society puts on people with mental illness. I feel like society has some kind of macabre desire for people like me to just do it already- to just put myself out of my misery, to free up the resources I use. And if I'm not going to do it, then just shut up about it. I don't know. I realize that all sounds pretty convoluted and messed up to say.

I also feel like it's a very personal process and someone I know trying to impress upon me what I should or shouldn't do feels worrying- makes me feel even more anxious.

What's your experience in reaching out to someone about this topic? Whenever I've done so I immediately regret it, I just end up feeling even more alone, ashamed, and depressed afterward- no matter how kind or good the listener was.

Also try if you can to nurture your body with sufficient food, rather than severely restricting. I know too well that it feels good to do, but it is a trap that is hard to break free from.

Good advise. One good thing is when I'm restricted I eat very healthy foods. My favorite is fruit (esp. apples) and natural peanut butter. I guess the bad part is I try to eat mostly "negative calorie" foods- like raw green veggies and such. And I don't eat enough of what I do choose- I eat just enough to take the edge off my hunger. I also eat throughout the day, in an effort to keep my metabolism and energy up. I eat for all the wrong reasons when I'm in this cycle!

... this year I have been pretty severely depressed for most of the time.

I do really hope you can convince yourself to see someone about medication. It must be so hard dealing with this on your own. I've found that talk therapy can make me feel way worse- but that meds have been very, very helpful. One of the best for my depression and anxiety was Effexor (venlafaxine)- but after two years, I started having bad side effects (constant sleepiness and brain fog) and needed to go off. But that was a "wonder drug" for me while it lasted. There are so many different meds out there, now, I'm sure there's someting- or a combo of meds- that would at least help take the edge of your depression- and maybe even your ED.

Hi Stella

I am glad to be able to help in any way I can, even if it is just having someone who understands to listen. This is a safe place to talk about whatever you need to without fear of being judged.

Thanks also for understanding about my difficulties. Writing about how I am feeling helps me too.

Have you always feared doctors? Did something traumatic happen- like one involuntarily committed you to the hospital? I realize it's what help looks like, but it also feels like such a GIANT breech of trust.

Yes and no! I've had a fear and mistrust of psychiatrists and all mental health workers for many years, due to bad treatment I've received on numerous occasions in the past, and in dealing with my eating disorder problems. It is true that being sent to hospital against my wishes didn't help, but it was the way in which it was done. I initially spent a period of almost 4 weeks on a general medical ward during my last admission, as my doctor and the psychiatrist and social worker told me I was being admitted just to 'stabilise me' and then I'd be allowed home to continue my treatment there. However, that didn't happen and they all conspired to have me sent to an eating disorder unit, even though I had complied with treatment in hospital and had been gaining weight. The reasons they used to send me to the EDU were trumped up lies, and I had such a traumatic time on the unit that it is hard to let go of my bad feelings towards everyone involved.

It is a very long and involved story, but I finally managed to get rid of monitoring by the psychiatrist and mental health team, and things reached a head with my doctor a couple of months ago to the extent that I removed myself from her list. It would be very difficult for me to trust again and, to be honest, I am not sure I can do it ever, even though I desperately need some help at the moment.

I'm glad you've had some good experiences and your psychiatrist and psychiatric nurse practitioner are helpful and supportive of you. I am so wary of medication that I've always refused antidepressants, even though in my younger life I was almost permanently on one type of antidepressant or another. I didn't find it helpful back then and fears of weight gain from medication put me off chancing it now.

But I DEFINITELY distrust therapists in particular. DBT class requires a once weekly individual therapy session and I dread it. I still haven't been able to get on board with this therapist. I'm so guarded, I carefully consider and control everything I say. But I've been heart broken by "bad" therapists in the past. I have an attachment disorder and now understand that most therapists don't know how to help me manage it- even when I explain that I have it and require help. So I have to be especially vigillant.

I completely understand where you are coming from here. I also suffer from attachment disorder problems and I found that none of the NHS therapists I saw ever understood this. My attachments don't manifest in feelings for therapists or anyone I have ever seen who has been treating me, but for other caring people who have come into my life and supported me in any way. I do have feelings of attachment for someone now, who luckily understands and has been supportive, but mental health people I saw always tried to 'break my attachment' by saying I should cut contact with her, which is never helpful or the answer.

briary wrote:I've experienced that feeling of peace and calm you mention. It was at a time I had made a definite decision to end my life, planned it out and everything.

This is one of the hardest things to bring up to anyone in "real" life. Harder even than my food problems. I feel like such a fraud. As if; Why am I still here if I'm saying I'm suicidal? I think I buy into the rhetoric and common criticism society puts on people with mental illness. I feel like society has some kind of macabre desire for people like me to just do it already- to just put myself out of my misery, to free up the resources I use. And if I'm not going to do it, then just shut up about it. I don't know. I realize that all sounds pretty convoluted and messed up to say.

I think that pretty much sums up how I feel about it too. I know I am telling the truth when I say I am feeling suicidal and that I've made plans of how I would do it, but the fact I am still here causes me to feel like I am lying, or just saying it to hurt people I care about. It's a tough one really because telling someone about it sometimes helps prevent the action of going through with it, even if the wish to die remains with me, but I also experience extreme guilt about it. I know I've had certain people telling me I am 'crying wolf', and that they no longer believe me that I will do it. Many people find the subject of suicide too difficult to even think about, let alone talk about with the suicidal person.

What's your experience in reaching out to someone about this topic? Whenever I've done so I immediately regret it, I just end up feeling even more alone, ashamed, and depressed afterward- no matter how kind or good the listener was.

I often feel bad that I've caused so much worry and upset to people I care about. Part of me also feels like I am a failure for not actually going through with it, even though those who care about me are always encouraging me to seek help and don't want me to act on my feelings.

I've had mixed reactions and mainly now I only tell a couple of people I trust more than anything. One doesn't want to know anything about it because she finds it too upsetting and difficult to cope with, and the other is very supportive of trying to encourage me to keep going and turn my life around. It is a very lonely place to be most of the time, but there are people who understand why life is so difficult that you feel this way, even if no one would ever encourage you to act the feelings. I certainly would never judge anyone, having been there myself.

One good thing is when I'm restricted I eat very healthy foods. My favorite is fruit (esp. apples) and natural peanut butter. I guess the bad part is I try to eat mostly "negative calorie" foods- like raw green veggies and such. And I don't eat enough of what I do choose- I eat just enough to take the edge off my hunger. I also eat throughout the day, in an effort to keep my metabolism and energy up. I eat for all the wrong reasons when I'm in this cycle!

Yes, a typical anorexic pattern of eating. I used to mainly live on fruit when restricting and, like you, I know deep down I wasn't eating enough to sustain my body but when I'm in that cycle I am so obsessed I am convinced I am eating loads.

I do really hope you can convince yourself to see someone about medication... One of the best for my depression and anxiety was Effexor (venlafaxine)- but after two years, I started having bad side effects (constant sleepiness and brain fog) and needed to go off. But that was a "wonder drug" for me while it lasted. There are so many different meds out there, now, I'm sure there's someting- or a combo of meds- that would at least help take the edge of your depression- and maybe even your ED.

Thanks and it is something I now think about, but I feel scared of actually trying anything, even though I couldn't feel much worse. If there were no worries about weight gain effects I probably would've given in a try ages ago.

Karen

Hi Karen- Had an appt. with my individual DBT therapist today. We were talking about the Prozac and so I brought up the increased suicidality- which was SO hard to do- like I'd mentioned before, I just felt like a fraud, a loser- I feel so ashamed of it, how could I feel anything else. It seems you can identify, from the sounds of your own experience with it.

And I did immediately regret it. She didn't discuss it or refer to it at all, didn't have any reaction. She just wanted to focus on the eating stuff after I mentioned it and spent the rest of the time on that. It really made me feel like a fool. I guess it made me feel she thinks I'm full of crap. Why do you think she opted to blow me off like that? It kind of makes me mad.

I have to run- more later, I suppose. Thanks for listening.

Hi Stella

I'm so sorry you had such a negative experience with you DBT therapist. I don't know why she didn't take what you were saying seriously, as being suicidal is a pretty serious affair. Did she not advise you to speak to your doctor or psychiatrist at least about the medication? The only thing I can think of is that she is there to do 'therapy' and perhaps thinks medication problems are outside her area of expertise.

However, that doesn't excuse the way her reaction, or lack of reaction, made you feel. I would've thought the idea of therapy is to discuss what you feel you need to discuss at the time, not to carry on with her agenda regardless of what else is going on. I saw a private CBT therapist for a while and she always used to ask me what I wanted to talk about during the session and we'd work out a list together.

I do understand how you feel and also know what it is like when other people dismiss your feelings. Please try not to let this set you back with the progress you've been making with the eating issues, even though I know it is hard not to.

When do you see your doctor or psychiatrist again?

Karen

Thanks, Karen, for your prompt and kind reply. I was pretty upset when I posted. Now that I've had the day to "marinate" on it, I've reminded myself that therapists are just people- and make mistakes, like all people. She was dismissive, you're right. And I really don't know why. I can only assume she was "doing the best she could" in the best way she knew how. You could be right- that medication stuff is out of her realm of expertise, so she didn't know how to address it. Maybe she thought that not paying attention to it would dispell the seriousness of it for me? Make me feel more at east somehow? Kind of like, "Yeah, oh that- suicidality- feh! No biggie- don't worry about that." I have no idea. I guess the only way I could know is to ask. Which I'm pretty certain I'm not going to do.

I've "radically accepted" (as they say in DBT) her response. I know I can't control that aspect- it is what it is. Right. I do know it left me feeling very alone with things. It's imparted the message that I'm on my own with that aspect. I guess I need to try and manage it myself at this point. It's just so hard to do alone with so MUCH crap- the ED stuff, the depression, the mood swings, the stress all piled on top of one another. It's just a lot.

And you're right - the eating issues are way up for me right now. I guess you know how stress can really ramp it up.

I actually got a call from my p-doc's office today that she needs to reschedule our next appointment. And this DBT therapist has a seminar next week so I won't be seeing her, either. *shrug* Sometimes it really feels like the "help" that exists just sets one up to fall flat on their face.

I can REALLY understand why you've come to distrust the mental health system so deeply. Very hard to know when it's safe to rely on it when it's so unpredictable- and even kind of cruel.

Maybe I'll have a better perspective on things tomorrow. We can always wait another day to see what tomorrow will bring, right?

Thanks, again.

Hi Stella

How has your weekend been? I'm sorry I haven't been around to reply to your last post but I've been struggling quite a lot myself.

I get entirely how alone and isolated all these emotions can cause you to feel and the taboo of talking about suicidal feelings just makes it even harder. Many people do not understand, or are scared to learn that someone they know is feeling so low and often I think people feel helpless in knowing what to say or do to help, even if the simplest things like a friendly and supportive ear mean so much when feeling so low.

You said the appointment with your psychiatrist has been rescheduled and I can understand that this is very bad timing and very unfortunate. Do you have another appointment arranged. Do you have your DBT group this week?

Although things seem very hard at the moment you have been doing well and there is a lot of support for you here. Don't give up.

Karen